The South Korean government is soliciting insurance companies to participate in a medical institution liability insurance program aimed at building a safety net for medical accidents. This year, the government will expand state-subsidized premium coverage to pediatric specialists at maternal-child medical centers, among others, to prevent the so-called "delivery room runaround" — cases in which expectant mothers are turned away due to a shortage of obstetricians and other medical staff.
The Ministry of Health and Welfare announced Tuesday that it will publicly recruit insurance companies to participate in the "Essential Medical Staff Liability Insurance Premium Support Program" from the 11th to the 26th of this month. The program, launched last year, subsidizes liability insurance premiums for medical personnel engaged in essential care, with the goal of encouraging medical institutions to take out liability insurance and establishing a medical accident safety net. The government concluded that the heavy compensation burden arising from medical accidents was deepening doctors' avoidance of essential care fields. It subsequently revised the Medical Dispute Mediation Act to make insurance enrollment mandatory for medical institutions and to establish a legal basis for state premium support.
This year, pediatric specialists at maternal-child medical centers and dedicated specialists at emergency medical institutions have been added to the list of eligible beneficiaries. Eligible specialists include obstetricians with delivery records, dedicated specialists at maternal-child medical centers (obstetrics, gynecology, and pediatrics), hospital-level pediatric surgeons, pediatric thoracic surgeons, pediatric cardiologists, pediatric neurosurgeons, and dedicated specialists at emergency medical institutions. Dedicated specialists at emergency medical institutions refer to those at regional emergency centers, regional trauma centers, and pediatric specialty centers, as well as specialists at regional emergency centers participating in the "Emergency Patient Transfer System Innovation Pilot Project." Dedicated specialists include not only those in emergency medicine but also specialists from other departments.
Medical procedures involving childbirth, pediatric surgery, and emergency care carry a high risk of large compensation claims when medical accidents occur. Under the new insurance scheme, medical institutions will bear up to approximately 150 million won of any compensation award, while the insurance will cover the excess portion up to 1.55 billion won. The government will subsidize approximately 1.75 million won (on an annual basis) per specialist toward the insurance premium. "This measure is intended to help medical staff at delivery rooms and emergency sites promptly accept and treat high-risk mothers and emergency patients without the burden of compensation for unavoidable medical accidents," the ministry said. "For dedicated specialists at emergency medical institutions participating in the Emergency Patient Transfer System Innovation Pilot Project, insurance coverage will be recognized retroactively for the period of their participation in the pilot project."
As was the case last year, eligible residents include those in internal medicine, surgery, obstetrics and gynecology, pediatrics, cardiovascular and thoracic surgery, emergency medicine, neurosurgery, and neurology. Under this scheme, training hospitals will bear up to approximately 20 million won of any compensation award, while the insurance will cover the excess portion up to 310 million won. The government will subsidize approximately 300,000 won (on an annual basis) per resident toward the insurance premium. Training hospitals employing essential care residents may opt for a refund of the equivalent amount on liability insurance they have already subscribed to.
The ministry will select insurers to design and operate the insurance products through the public recruitment process and will support medical institutions in enrolling in the selected insurers' products. To facilitate enrollment, applications will be accepted on a rolling basis from June through November, and the ministry will work with relevant organizations to encourage medical institutions to sign up. A selection review committee will evaluate the feasibility of business plans and execution capacity, and will choose insurers based on premium rates, deductibles, and payment and review plans. Interested companies must submit their applications to the Korea Medical Dispute Mediation and Arbitration Agency by the 26th.
